Abstract | BACKGROUND & AIMS: METHODS: We collected data from 2666 adults positive for hepatitis B surface antigen ( HBsAg), infected with HBV genotypes B or C, and without liver cirrhosis, who had long-term follow-up at the National Taiwan University Hospital from 1985 through 2000. None of the patients received antiviral treatment during the follow-up. Baseline levels of HBV DNA, HBsAg, and HBcrAg were determined retrospectively and participants were followed for a mean of 15.95 years. The primary end point was an association between serum level of HBcrAg and HCC development. RESULTS: HCC developed in 209 patients in the cohort (incidence rate, 4.91 cases/1000 person-years). We found a positive association between baseline level of HBcrAg and HCC development; HBcrAg level was an independent risk factor in multivariable analysis. In the subgroup of hepatitis B e antigen-negative patients with HBV DNA levels from 2000 to 19,999 IU/mL (intermediate viral load [IVL]) and normal levels of alanine aminotransferase, HBcrAg levels of 10 KU/mL or more identified patients at increased risk of HCC (hazard ratio, 6.29; confidence interval, 2.27-17.48). Patients with an IVL and a high level of HBcrAg had a risk for HCC that did not differ significantly from that of patients with a high viral load (≥20,000 IU/mL). Patients with an IVL but a low level of HBcrAg had a low risk of HCC, with an annual incidence rate of 0.10% (95% confidence interval, 0.04%-0.24%). CONCLUSIONS: In a long-term follow-up study of 2666 patients with chronic HBV infection (genotypes B or C), level of HBcrAg is an independent risk factor of HCC. Moreover, HBcrAg level of 10 KU/mL identifies patients with an IVL who are at high risk for HCC.
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Authors | Tai-Chung Tseng, Chun-Jen Liu, Chen-Yang Hsu, Chun-Ming Hong, Tung-Hung Su, Wan-Ting Yang, Chi-Ling Chen, Hung-Chih Yang, Yen-Tsung Huang, Stephanie Fang-Tzu Kuo, Chen-Hua Liu, Pei-Jer Chen, Ding-Shinn Chen, Jia-Horng Kao |
Journal | Gastroenterology
(Gastroenterology)
Vol. 157
Issue 6
Pg. 1518-1529.e3
(12 2019)
ISSN: 1528-0012 [Electronic] United States |
PMID | 31470004
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Biomarkers
- DNA, Circular
- DNA, Viral
- Hepatitis B Antigens
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Topics |
- Adult
- Biomarkers
(blood)
- Carcinoma, Hepatocellular
(epidemiology, virology)
- DNA, Circular
(blood)
- DNA, Viral
(blood)
- Female
- Follow-Up Studies
- Hepatitis B Antigens
(blood)
- Hepatitis B virus
(immunology, isolation & purification)
- Hepatitis B, Chronic
(blood, complications, virology)
- Humans
- Incidence
- Liver Neoplasms
(epidemiology, virology)
- Male
- Middle Aged
- Retrospective Studies
- Risk Factors
- Taiwan
(epidemiology)
- Viral Load
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